Provider Demographics
NPI:1316017957
Name:ZEKAVAT, PARVIN (DDS)
Entity Type:Individual
Prefix:
First Name:PARVIN
Middle Name:
Last Name:ZEKAVAT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25870 WEBSTER PLACE
Mailing Address - Street 2:
Mailing Address - City:STEVENSON RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91381
Mailing Address - Country:US
Mailing Address - Phone:661-254-0544
Mailing Address - Fax:661-254-0544
Practice Address - Street 1:38745 N TIERRA SUBIDA
Practice Address - Street 2:#150 SMILE CARE FAMILY DENTAL GROUP
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551
Practice Address - Country:US
Practice Address - Phone:661-272-9091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAU6352122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist